Medicare Referring Provider DMEPOS Data CY2016
The 2016 Referring Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Public Use File (herein referred to as “Referring Provider DMEPOS PUF”) presents information on DMEPOS products and services provided to Medicare beneficiaries ordered by physicians and other healthcare professionals. The Referring Provider DMEPOS PUF contains data on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code and supplier rental indicator. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program available from the CMS Chronic Condition Data Warehouse (www.ccwdata.org). The data in the Referring Provider DMEPOS PUF covers calendar year 2016 and contains final-action (i.e., all claim adjustments have been resolved) Part B non-institutional DMEPOS line items for the Medicare fee-for-service (FFS) population.
While the Referring Provider DMEPOS PUF has a wealth of information on payment and utilization for Medicare DMEPOS services, the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physician’s entire practice as it only includes information on Medicare fee-for-service beneficiaries. In addition, the data are not intended to indicate the quality of care provided and are not risk-adjusted to account for differences in underlying severity of disease of patient populations. For additional limitations, please review the methodology document available below.
Data are available in two formats:
- Tab delimited file format (requires importing into database or statistical software; SAS® read-in language is included in the download ZIP package).
- Interactive format on Data.CMS.gov. This interface allows the data to be filtered, sorted, and exported.
CMS has also created two summary files: 1) aggregated information by referring provider and 2) aggregated information by Nation/State and HCPCS code. A detailed methodology document can be found in the Downloads section below which contains important information regarding the limitations of data usage.
Interactive Dataset: Medicare Referring Provider DMEPOS PUF, CY2016, Interactive Dataset
Download Full Data File: Medicare Referring Provider DMEPOS PUF, CY2016, Tab Delimited format
[Note: This Compressed ZIP package contains the tab delimited data file (Medicare_Referring_Provider_DMEPOS_PUF_CY2016.tab) which is 511MB uncompressed and contains more than 1.7 million records, thus importing this file into Microsoft Excel will result in an incomplete loading of data. Use of database or statistical software is required; a SAS® read-in statement is supplied. Additionally, this ZIP package contains the following supporting document: Medicare-Referring-Provider-DMEPOS-PUF-SAS-Infile.sas]
Provider Summary Tables:
Interactive Dataset: Medicare Referring Provider DMEPOS NPI Aggregate table, CY2016, Interactive Dataset
Product Summary Tables:
Interactive Dataset: Medicare National DMEPOS HCPCS Aggregate table, CY2016, Interactive Dataset
Downloadable Excel: Medicare National DMEPOS HCPCS Aggregate table, CY2016, Microsoft Excel (.xlsx) (ZIP)
Interactive Dataset: Medicare State DMEPOS HCPCS Aggregate table, CY2016, Interactive Dataset
Downloadable Excel: Medicare State DMEPOS HCPCS Aggregate table, CY2016, Microsoft Excel (.xlsx) (ZIP)
Inquiries regarding this data can be sent to MedicareProviderData@cms.hhs.gov.
To receive email notifications, please sign up for the Medicare Provider Data GovDelivery subscription here.